AR & Salesforce Case Representative (Virginia)

We need to output HTML fragment with sections: About the role? Actually we need to use headings for sections like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to include only sections with real content. The posting includes Company Description, Job Description (responsibilities), Qualifications, Pay info (hourly range, bonus), maybe Benefits (mentions medical, dental, vision, life, pet insurance, 401K, paid time off, wellness programs). Also maybe Schedule? Not mentioned. So we can include sections: About the role (maybe from Company Description?), Responsibilities (from Job Description), Qualifications, Skills (maybe from qualifications like Excel, Salesforce, etc.), Benefits, Pay. We must not repeat job title. Also we must not include boilerplate like EEO, legal, etc. Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. Also remove Technical Requirements? It's not a required section but could be part of Qualifications? It's about remote work internet speed. Might be considered a qualification? Could include under Qualifications or Skills. But we can keep as part of Qualifications (maybe as a note). However we should not invent sections. We'll include sections with actual content. We need to preserve all substantive information. So we need to include details: Company description (maybe as About the role). Job description responsibilities list: processing claims, reviewing correspondence, answering SalesForce cases, resolving claim issues, overseeing AR functions, serving as SME, managing AR analysis, writing rules, denial management, independent decisions, escalation, suggest policy updates, work with practice consultants/physicians via Salesforce, driving KPI attainment, other duties. Qualifications: High School Graduate, 5+ years experience in physician medical billing office or equivalent claims experience, understand drivers of revenue cycle optimal performance, investigate/resolve complex claims, Microsoft Excel skills preferred, experience with athenaOne preferred, experience using Salesforce for case management preferred, must provide accessibility to private quiet workspace with high-speed internet to work remotely (if remote), experience with VA payers & providers preferred, must comply with HIPAA, excellent written and verbal communication. Skills: Could list Excel, Salesforce, athenaOne, etc. But we already have them in qualifications; we could still have a Skills section summarizing those. However we must not duplicate content? The instruction: Preserve ALL substantive information; do NOT invent or summarize away detail. So we need to keep the details; we can put them in Qualifications or Skills but not lose them. If we put them in Qualifications, that's fine. We could also have a Skills section that lists specific skills (Excel, Salesforce, athenaOne, HIPAA, communication). But that would be summarizing; but we could still keep the details as list items. It's okay to have overlapping? Might be considered duplication but not prohibited. Safer to put all qualification details under Qualifications section, and maybe not have a separate Skills section unless there are distinct skill items not covered. The qualifications already include skills like Excel, Salesforce, athenaOne, HIPAA, communication. So we can skip Skills section. Benefits: medical, dental, vision, life, pet insurance, 401K, paid time off, other wellness programs. Pay: hourly range $23/hr to $26/hr, exclusive of bonuses/benefits, eligible for annual bonus targeted at 10%, base pay determined based on experience, education, geographic location. Schedule: not mentioned, so omit. We also need to include maybe a short paragraph for metadata like Job ID? Not needed. We must not include boilerplate like EEO, legal, etc. So we remove the Additional Information paragraph about confidentiality, technical requirements, etc. Also remove the "Privia Health is committed..." EEO statement. Also remove the technical requirements about internet speed? That's substantive for remote workers; maybe we should keep it as part of Qualifications (as a requirement). It's not boilerplate; it's a requirement for remote work. So we should keep that. The "Additional Information" includes confidentiality according to EEO guidelines (boilerplate) and technical requirements (which is substantive). We need to separate: keep the technical requirements (internet speed, expense reimbursement) but drop the EEO confidentiality line. Also drop the EEO statement at end. Thus we need to parse the text and keep relevant bits. Let's extract: Company Description: Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers. Job Description: The AR Manager is responsible for complete, accurate and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices in a timely manner, answering incoming SalesForce cases and providing information as requested or properly authorized. The AR Manager will take steps necessary to resolve all claim issues or questions that escalate to the RCM team. Resolution of SalesForce cases and management of issues and the team resolving the cases is a key element in this role. Additionally, the Senior AR Manager is responsible for overseeing functions within Accounts Receivable in accordance with compliant best practices, such as Claims Worklists, Zero Pay, Unapplied, and Denials, to ensure that all are reviewed, reconciled and resolved in a timely matter. The Senior AR Manager will also serve as an subject matter expert and point of escalation on one of our internal sub-teams. Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; writing rules where appropriate to stop errors from occurring.Denial management - investigating denial sources, resolving and appealing denials which may include contacting payer representatives.Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.Serves as an escalation point, and escalates issues to the appropriate party.Suggest and run point on policy updates as needed.Work directly with practice consultants and/or physicians via Salesforce to ensure optimal revenue cycle functionalityFocused on driving toward achievement of department’s daily and monthly Key Performance Indicators (KPIs), requiring a team focused approach to attainment of these goals.Other duties as assigned Qualifications: High School Graduate.5+ years experience in a physician medical billing office or equivalent claims experienceMust understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claimsMicrosoft Excel skills (ex: pivot tables, VLOOKUP, sort/filtering, formulas) preferredExperience working with athenaOne preferred Experience using Salesforce for case management preferredMust provide accessibility to private, quiet work space with high-speed internet to effectively work remotely (if a remote worker)Experience with VA payers & providers preferred Must comply with HIPAA rules and regulationsExcellent written and verbal communication Pay/Benefits: The hourly range for this role is $23/hr to $26/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information (technical requirements): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. We should keep the technical requirements as part of Qualifications or maybe a separate section like "Remote Work Requirements". But we only have allowed headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. "Requirements" could be used for technical requirements. However the instruction says use headings for those specific section headings. It didn't forbid other headings? It says use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can use those headings. So we can have a "Requirements" section for technical requirements (internet speed, workspace, etc.) and keep Qualifications for experience/education etc. That seems appropriate. Thus sections: - About the role: Company Description. - Responsibilities: Job Description (list of duties). - Requirements: Technical requirements (remote work internet speed, private quiet workspace, expense reimbursement). Also maybe include "Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely (if a remote worker)" and "Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost." Also the minimum speed specs. - Qualifications: Education/experience, Excel, athenaOne, Salesforce, VA payers, HIPAA, communication. - Benefits: medical, dental, vision, life, pet insurance, 401K, paid time off, other wellness programs. - Pay: hourly range $23-26, annual bonus 10%, base pay determined by experience, education, location. We should not include Schedule. We need to format responsibilities as

• items. Also qualifications as list. Benefits as list. Requirements as list. Pay maybe as

  with details. We must not repeat job title. Not include any boilerplate. We must output only HTML fragment. Let's craft. First,

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  • each duty. We need to split duties into sensible items. The description is long; we can break into bullet points: - Process designated claims completely, accurately, and timely. - Review and respond to daily correspondence from physician practices promptly. - Answer incoming SalesForce cases and provide requested or authorized information. - Resolve claim issues or questions that escalate to the RCM team. - Manage SalesForce case resolution and oversee the team handling cases. - Oversee AR functions (Claims Worklists, Zero Pay, Unapplied, Denials) ensuring review, reconciliation, and timely resolution. - Serve as subject matter expert and point of escalation for an internal sub-team. - Analyze aged AR to identify root cause issues; write rules to prevent errors. - Conduct denial management: investigate sources, resolve and appeal denials, including contacting payer representatives. - Make independent decisions on claim adjustments, resubmission, appeals, and other resolution techniques. - Act as escalation point and route issues to appropriate parties. - Suggest and lead policy updates as needed. - Collaborate with practice consultants and/or physicians via Salesforce to optimize revenue cycle functionality. - Drive achievement of departmental daily and monthly KPIs through a team-focused approach. - Perform other duties as assigned. That captures all. Now Requirements (technical): list: - Minimum 5 Mbps download speed and 3 Mbps upload speed for remote work. - Must have access to a private, quiet workspace with high-speed internet to work remotely (if applicable). - Employees regularly working from home are eligible for expense reimbursement to offset internet costs. We could also include that this should be acquired prior to start of employment, and use speedtest.net to verify. Might be included as details. We'll include as list items. Qualifications list: - High school graduate or equivalent. - 5+ years of experience in a physician medical billing office or equivalent claims experience. - Understanding of revenue cycle optimal performance drivers; ability to investigate and resolve complex claims. - Proficiency with Microsoft Excel (pivot tables, VLOOKUP